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Certification Commission Policy and Procedure Manual

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APPENDIX 3 D cont’d<br />

APPLICANT:<br />

Page 2<br />

DATE:<br />

Has the Applicant Maintained Faith Group Endorsement? (See Appendix 5 ACPE<br />

Ecclesiastical Endorsement Conflict Resolution <strong>Policy</strong>) ____ Yes ____ No<br />

Evaluate the Following Professional Competencies: (<strong>Certification</strong> as an Associate<br />

Supervisor requires a "satisfactory" rating in each of these four categories.) (See current<br />

edition of ACPE STANDARDS)<br />

A. Supervisory Competence St<strong>and</strong>ard 406<br />

__________ Satisfactory<br />

__________ Unsatisfactory<br />

B. Conceptual Competence St<strong>and</strong>ard 407<br />

__________ Satisfactory<br />

__________ Unsatisfactory<br />

C. Collegial Competence St<strong>and</strong>ard 410.2<br />

__________ Satisfactory<br />

__________ Unsatisfactory<br />

Further address Items A. - C. as needed:<br />

22

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